| NPI | 1811135981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: UT 7470020-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 39) |
| Enumeration Date | 2009-01-28 |
| Last Update Date | 2016-04-26 |